4. ANAPHYLACTIC
SHOCK
• Type 1 IgE mediated reaction due to allergen
• Mast cell degranulation
• Histamine and prostaglandin release
• Dilated & permeable blood vessels
• Hypotension
• Release of leukotrienes
• Smooth muscle contraction
5. MEDICAL EMERGENCY
• ABC
• Adrenaline 0.5mg IM!!
• Repeat every 5 minutes if needed
• Oxygen
• IV access
• Hydrocortisone 200mg IV & Chlorphenamine 10mg IV
• Fluids
NB
• Measure tryptase
• Monitor for 6-8 hours
6. CARDIOGENIC SHOCK
• Hypo-perfusion of tissues due to cardiac dysfunction
• HIGH mortality
• Can occur acute or progressively
• Causes include; MI, PE, arrhythmias, heart failure
7. MANAGEMENT OF
CARDIOGENIC?
• ABC
• Oxygen
• IV diamorphine (2.5-5mg)
• Investigations
• ECG, U&Es, Cardiac enzymes, ABG, CxR, Echo
• Close monitoring of
• CVP, BP, ABG, urine output *catheterize, ECG **hourly
8. HYPOVOLAEMIC
SHOCK
• Haemorrhage OR Fluid loss
• Severe
• Blood loss of >2L
• Tachycardia >140bpm
• Low BP
• Tachypnea/Respiratory collapse
• Cold, mottled skin
• Obtund
• Anuria
9. MANAGEMENT
• BP unrecordable? Call crash team!
• ABC (high flow O2)
• IV access x 2
• FLUIDS FAST
• (Blood if blood loss)
• Treat underlying cause
• Ring for help
10. NEUROGENIC SHOCK
• Disruption of autonomic pathways within spinal cord
• E.g. post-spinal surgery/blunt trauma
• Loss of stimuli for blood vessels
Dilate & reduce vascular resistance
Hypotension
• Management
• ABC
• Oxygen
• Fluids
• Vasopressors/inotropes if required.
11. SEPTIC SHOCK
• Endotoxin induced vasodilatation
• Fever
• ABC, oxygen
• IV antibiotics within 1hour (blood cultures before if possible)
• Refer to ITU
